Mental health
The mind is your Operating System. A healthy mind helps you function well in school, at work, in relationships. It allows you to lead a fulfilling life. But a healthy mind does not come by chance, you need to care for your mind and maintain it.
Here are some useful mental habits to practise, based on research and real life experience. For more details on how to apply these habits, follow my blog!
Keep a Wellness Account
Take note of withdrawals and deposits in your wellness account.
Withdrawals could be stressors happening in life that are beyond our control, or they could be choices we make that drain our energy or well-being. Deposits are things going well in life or choices we make that improve our well-being.
Do check your "statement" frequently and keep a healthy balance in your account!
Understand how the mind works
Everyday, we have thousands of thoughts going through our minds, most of which we may not even notice. Some of these thoughts influence our emotions and behaviours. Learn to observe your thoughts and ask yourself: is this thought helping me or hurting me?
Negative thoughts may come from past experiences, low self-esteem, or due to depressed and anxious mood states. Whether the negative thoughts continue to grow in your mind, depends on whether you continue to feed them with attention.
Practise directing your attention towards helpful thoughts, and your emotions will gradually follow. You can also choose to engage in behaviours that lift your mood, for example being kind to someone, walking/jogging in the park, admiring the beauty of nature, or counting your blessings.
These are mental habits, and just like any other habit, need time and repeated practice to change, so keep going and you will see results eventually.
*The above tips help to maintain a healthy mind and may prevent mental health conditions. However, for someone already in the midst of a mental illness, it may not be easy to follow the above tips on their own effort. See the next section on mental illness.
Mental illness
Let's drop the stigma and negative connotations related to mental illness.
Mental health is simply the other aspect of our health, besides physical health. Just like our physical state can become ill, our mental state can become ill too.
Among all the mental illnesses, depression and anxiety are among the most commonly experienced. Worldwide estimates quote up to 20% prevalence rate for mood disorders, meaning that 1 in 5 people may get depression, bipolar disorder or anxiety disorder in their lifetime. The Singapore Mental Health Study 2016 showed 1 in 7 people in Singapore suffered from mood, anxiety or alcohol use disorders in their lifetime.
People with mild to moderate forms of mental illness, especially if they have sought treatment, would usually be able to function in their daily routines, such that others don't even realise there is anything different about them. Many assumptions prevailing in society about mental illness (eg. people with mental illness are crazy, violent, unable to work) are just misguided stereotypes.
That said, the internal experience of the person with mental illness is often a huge struggle. Depending on the exact condition, functions such as concentration, decision-making, energy levels, sleep, motivation, etc. may be affected.
In order to carry out their usual responsibilities, people with mental illness often have to exert more effort to get things done, and they also worry about how others may perceive them. These struggles are often experienced internally, not visible to others, which is why many people still do not understand the difficulties faced by the mentally ill. One of the worst comments you can give to someone with mental illness is, "but you look fine!" because it could be taken to mean they don't seem all that ill, and it minimises the difficulties faced by those fighting mental illness. A more helpful response could be, "Sorry, I didn't know what you have been dealing with."
Professional treatment and family support are crucial in helping someone recover from mental illness. Mild to moderate levels of depression and anxiety may do well with counselling / psychological therapy, while moderate to severe conditions might need medication to manage the symptoms, so that therapy can help with regaining confidence and learning coping skills.
Cognitive Behavioural Therapy (CBT) is an evidence-based approach commonly used for treating depression and anxiety. Self-help books and online programmes can be helpful for preventing and coping with such conditions, though individual assessment and treatment would still be best for someone struggling in their mental health.
Here's a site where you can read up more about various mental health conditions.
https://www.drugwatch.com/health/mental-health/mental-illness/
What causes mental illness?
It is often difficult to prove causality, just like the chicken and egg question (which came first, the chicken or the egg?). However, we can understand risk factors and work towards minimising risk.
The human brain is so complex that there are still aspects waiting to be discovered, but what we do know is that mental health is influenced by biological, psychological and social factors. Scientists call this the bio-psycho-social model. While genetic factors are not within our control, we can learn to care for psychological and social factors so that we have the best chance of having a healthy, well-functioning mind.
Biological factors
Like many other diseases, genes play a part in our susceptibility. A family history of mental illness increases the chances of a person developing mental illness at some point in his/her life. Note this does not mean a definite illness, it just increases the risk as compared to someone else without a family history, all other factors equal.
Long periods of maternal stress during pregnancy can also affect the baby’s brain development in such a way that the child is at higher risk of developing behavioural or mental health problems. Hence this is another reason for all adults to learn how to manage stress in healthy ways, to prevent intergenerational mental health issues. One of the best gifts you can provide for your child is to have a healthy start in the womb.
Our physical health and mental health are closely linked. People suffering from chronic diseases are more likely to develop mood problems, and people struggling with mental illness frequently don't have the motivation and means to take good care of their physical health either. Here is a site that illustrates even our eye health can be related to mental health.
Psychological factors
Certain personality traits, such as being perfectionistic or rigid in thinking, places the person at constant high levels of stress, and even more so when life (or other people) does not go according to how they want it to be. Our beliefs, feelings, coping skills and how we perceive situations also influence how we respond to changes and challenges in life, thereby triggering additional situations and affecting our mental health.
We may not be able to totally change our personalities, but we can learn to manage specific personality traits such that we use them where it helps (eg. excel at a work task) and tone down where it may hinder us (eg. being perfectionistic all the time will likely lead to interpersonal conflicts and high blood pressure).
We can also learn psychological strategies that help us maintain healthy, balanced perspectives and manage the inevitable negative emotions in life without being destructive to ourselves or to people around us. Resilience is a psychological quality that can be learned and nurtured.
Environmental/Social factors
Environmental stress includes academic / job demands, as well as social situations and other life circumstances. Like an overstretched rubber band, our mental health would thin out or even break when demands are persistently more than what we can handle.
Family relationships play a big part in our mental health. The family is usually where we developed most of our beliefs about life and where we most want to seek comfort from. Our self-esteem, emotional regulation skills, interactions with others outside the home are often shaped by influences from the family we grew up in. Ideally, the family provides a nurturing environment in which children grow to become adults with positive self-esteem, life skills such as the ability to manage emotions and relationships in healthy ways. However, not everyone is blessed with such a family environment.
Regardless of the exact stressor(s) faced, we are all humans with limited resources. There would be times when a person runs out of physical or mental energy to deal with challenging circumstances. Extended periods of experiencing negative emotions without the relevant skills and support to cope could possibly tip the scale and lead to mental illness.
For more details on the biopsychosocial model of mental health, you may click here.
Here’s a quick YouTube video if you prefer a visual explanation.
Practise mindfulness
Practising mindfulness can increase our awareness, improve focus, and help with general well-being, among many other benefits. Simply put, being mindful means being aware, paying attention to the present moment. It sounds easy, but if you really tried to focus on one single thing, you would find that the mind has a habit of wandering and trying to multi-task (which research has shown to be counterproductive, by the way).
A simple form of mindfulness can be practised in our daily activities. Here are some examples:
- Bring your attention to the current task you are doing and whenever you notice your attention drifting, bring it back to the task; OR
- Use your senses (sight, hearing, touch, taste, smell) to observe and be aware of your present surroundings and body reactions; OR
- Observe your own internal states and make conscious choices for your behaviours in each moment
To truly appreciate the experience and deepen your understanding of the concept, we recommend formal mindfulness practice where you set aside a specific amount of time to focus on a chosen "object of attention" (which could be your breath, or body sensations, or a topic such as kindness, among many others). There are several apps useful for this, though there are added benefits of practising under a trained instructor so any doubts could be clarified.
Although there are origins and overlaps between mindfulness and Buddhist practices, our mention of mindfulness here refers to psychological awareness and applications in life. Mindfulness in secular (non-religious) form is increasingly being used in medical settings for stress, pain and chronic illnesses, with research evidence showing how participants cope better after attending mindfulness programmes. There is also research showing brain changes with regular practice, such that the thinking / problem-solving part of the brain (pre-frontal cortex) grows, while the stress reaction part (amygdala) becomes less active.
Useful links
The Singapore Association for Mental Health is a great local site to start understanding more about mental wellness, illness and relevant support services.
Silver Ribbon Singapore advocates for mental wellness in the community, schools and workplaces. They also have a free counselling service and a mental health crisis resolution team.
Mindline.sg uses AI technology to provide relevant resources for you, based on your responses to some simple questions.
Okay.gov.sg is Singapore's most comprehensive mental wellbeing guide to date, with well-organised information and resources to help you manage, improve and maintain your mental health.
Here is another website with comprehensive information on mental health. https://www.drugwatch.com/health/mental-health/
If you need support but find it too anxiety-provoking to meet a counsellor face-to-face, you may consider this e-Counselling Centre run by Fei Yue Community Services.
Shan You, a social service agency, launched a community project in 2018 titled 'The Elephant in Our Community' to raise awareness on mental health issues. You can find brochures on their website related to common challenges in mental health and evidence-based treatment modalities.
Clarity Singapore is another social service focusing on mental health, offering professional counselling services at very affordable rates. They also run public workshops regularly, and there are many articles on their website to help you understand more about mental health conditions and coping strategies.
To learn more about mindfulness, find workshops and try some audio-guided exercises, check out Brahm Centre and Centre for Mindfulness.
I also love the Smiling Mind App as it is free and has many exercises of varying durations to choose from.
For urgent mental health support in Singapore, please call the following 24-hr helplines: 1800-221-4444 (Samaritans of Singapore), or 6389 2222 (Institute of Mental Health).